Elisabeth Dykens - US grants

DESCRIPTION (adapted from the applicant's abstract): Prader-Willi syndrome (PWS) has long been characterized by hyperphagia, food obsessions, and increased risks of obesity in affected individuals. Although less well-described, many people with PWS show obsessions and compulsions not related to food, as well as significant behavioral dysfunction. The proposed study will examine these obsessions, compulsions, and other maladaptive features, filling a long-standing behavioral research void in this complex developmental disorder. To this aim, the investigators propose to identify the onset, course, and phenomenology of obsessive-compulsive symptoms in PWS, and how these relate to children with obsessive-compulsive disorder (OCD). PWS is hypothesized to represent a specific clinical subtype of OCD, opening up possible roles for genomic imprinting or the PWS Critical Region in delineating these subtypes. It is hypothesized that compulsivity in PWS has an unusually early-onset, and that salient features of the PWS cognitive-behavioral phenotype may provide new clues into how compulsivity is expressed in young children. Early-onset compulsivity is also likely associated with aspects of hyperphagia and of normative development. The second aim is to identify possible mechanisms in PWS that mediate the expression of compulsivity. The proposed study hypothesizes that whole-blood serotonin will mediate symptom expression, and that subtle differences in symptoms may be seen across PWS subjects with paternally-derived deletions at 15q11-q13 versus those with maternal uniparental disomy of chromosome 15. Third, the investigators aim to determine the distinctiveness of compulsivity in PWS relative to children with Williams syndrome (WS), and Down syndrome (DS). WS is a particularly powerful contrast group as it is characterized by increased anxiety and obsessional thinking. The three aims will be addressed in two ways: 1) a longitudinal study of 60 children with PWS, WS, and DS aged 2 to 7 years who are tested twice, two years apart; and 2) a cross-sectional study of 35 children with PWS aged 10-14 years who are compared to subjects with WS, DS, and appropriately matched children with OCD. Findings will shed new light on treatment, on certain subtypes of OCD, and on the range and correlates of PWS' complex behavioral phenotype.

DESCRIPTION (provided by applicant): In addition to its unique genetic features, Prader-Willi syndrome (PWS) is associated with a distinctive behavioral phenotype. Hyperphagia is invariably seen, as are externalizing problems such as temper tantrums and aggression, and a host of compulsive-like behaviors that place affected individuals at high risk for obsessive compulsive disorder (OCD). All these problems are, on average, more frequent and severe than others with mental retardation, and they typically impede the adaptive functioning and life success of persons with PWS. This continuation builds on our previous work by examining both environmental and biological moderators of psychopathological outcome in children and adolescents with PWS. In Specific Aim 1, we clarify the factor structure of compulsive-like symptoms in PWS and also provide the only quantitative assessment to date of hyperphagic symptoms in this disorder. These factor analytic studies assess compulsive-like behavior and food symptoms one time only in 150 participants with PWS aged 4 to 14 years. While Specific Aim 1 fine-tunes outcome variables, Specific Aims 2 and 3 form the centerpiece of the grant, and examine how family and child variables moderate psychopathological outcome. In Specific Aim 2 we assess how family stress, maternal coping, and specific interactions between mothers and children moderate different factors of compulsivity, hyperphagia and other problems (and also how child problems differentially moderate family functioning). In Specific Aim 3 we examine how such child factors as age, genetic subtypes of PWS (paternal deletion of 15ql I-q13 versus maternal uniparental disomy), and serotonergic functioning are associated with compulsivity, hyperphagia and other problems. These two Aims, then, begin to explain individual differences in the behavioral phenotype of PWS, and ultimately, why some individuals have more successful life outcomes than others. To this aim, the continuation uses a within-syndrome, longitudinal design with 40 persons aged 4 to 14 years who are assessed at several time points over a 5-year period. We have already followed approximately 60% of these 40 participants, providing a firm foundation for the continuation. The 4 to 14 year age period is one when compulsive-like, hyperphagic, and other behavioral problems are increasingly seen, and as such we can track both the emergence and correlates of these problems. As participants will be assessed from 3 to 4 times, individual growth curve modeling techniques will be used to identify the trajectory and correlates of compulsivity, hyperphagia, and other problems. Findings will further delineate the PWS phenotype across genetic subtypes, and for the first time ever, elucidate both environmental and biological correlates of psychopathology in this syndrome.

The objectives of this core are: (1) To provide KC investigators with access to clinical research populations through ongoing and new liaisons with community and state agencies, diverse clinics, and a host of existing databases. Specifically, the core: - Facilitates access to a variety of clinical settings and serves as a liaison to Kennedy Center related clinics, including the Susan Gray School, Vanderbilt Kennedy Reading Clinic, Vanderbilt Kennedy Behavior Analysis Clinic, Vanderbilt Kennedy Family Outreach Center, and the Vanderbilt Down syndrome Clinic. - Sustains and promotes successful partnerships with community and state disability programs that facilitate research participation. - Facilitates access to existing clinical databases for recruitment and research purposes, identifies new databases for use by KC investigators, and develops and maintains KC databases as needed. (2) To assist investigators with state-of-the-art psychological and behavioral assessments, which contribute to the broader gene-brain-behavior research agenda of KC investigators. Specifically, the core: - Assists investigators with training and administration of standardized neuropsychological, psychiatric, psychosocial, and educational assessments, especially in highly researched populations (e.g., autism, Down Syndrome). - Broadens the scope of behavioral domains within assessments. - Develops novel assessments as needed. - Contributes to the literature on assessment of persons with mental retardation.

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DESCRIPTION (provided by applicant): The John F. Kennedy Center for Research on Human Development (KC) at Vanderbilt University is a Mental Retardation Developmental Disabilities Research Center (MRDDRC) in its 39th year of support from NICHD. The KC has a specific objective of supporting research in four major program areas: 1) Communication and Learning, 2) Developmental Neurobiology and Plasticity, 3) Mood and Emotion, and 4) Family Research. In 2001, Vanderbilt designated the KC as a university-wide institute and provided the resources to recruit additional faculty over the next five years. These changes expand the community of Vanderbilt scientists who are dedicated to better understanding and treating the genetic and environmental conditions that give rise to abnormalities in brain and behavioral development. Currently, 72 KC investigators receive federal support for more than 90 projects, which include studies in basic neuroscience and genetics, communication and cognitive disorders, special education, and developmental and clinical psychology. Approximately half of KC investigators utilize model systems in basic research, incorporating powerful genetic and experimental methods to study the genetic and environmental regulation of brain development, mechanisms of neuronal communication, and cellular and functional brain plasticity after injury or damage caused by gene mutations. Clinical researchers comprise half of the research efforts in the KC, and use multidisciplinary approaches to study language development, reading and math skills, the relationship between behavioral and cognitive dysfunction, regulation of emotional states, the short- and long-term impact of developmental disabilities on family relationships, and the neurogenetic and environmental contributions to mental retardation. Multidisciplinary projects involve the integration of cognitive and behavioral sciences with neuroscience and genetic methods to investigate disorders such as autism, mental retardation, Prader-Willi and Williams syndromes, aggression, ADHD, depression, anxiety, and learning disabilities. Four core services are proposed to support these research efforts: (A) Administrative, (B) Neuroscience, (C) Technology and Informatics, (D) Clinical Research and Assessment.

DESCRIPTION (provided by applicant): This application addresses the Broad Challenge area of Comparative Effectiveness Research (05), 05-AT-102* Comparative Effectiveness Studies of Complementary and Alternative Medicine. This application is entitled: Conventional vs Mindfulness Intervention in Parents of Children with Disabilities. A full 1 in 5 children in the US has a developmental disability, and the prevalence rate for autism spectrum disorders (ASD) is especially high (1 in 150 children). As many as 20% of US families are raising children with developmental disabilities, and these parents experience more stress than parents of typically- developing children, as well as more depression, anxiety, and health and mental health problems. Negative outcomes are complicated by increased economic hardships faced by families of children with disabilities. Although parental stress is elevated in many types of disabilities, parents of children with ASD are especially prone to negative psychological and economic outcomes. This application compares the effectiveness of a conventional Parent Group intervention to a modified Mindfulness- Based Stress Reduction (MBSR) program in parents of children with ASD and other disabilities. Parent groups are widely-used to provide information, support, and advocacy. MBSR is efficacious for people with medical, psychiatric or other concerns, and teaches stress reduction through mindfulness training and practice. In contrast to conventional parent groups, our studies suggest that mindfulness-based interventions may be particularly effective in reducing stress and improving the health and mental health of parents of children with disabilities. We will randomly assign 400 parents of children with ASD or other disabilities to 6 weeks of a Parent Group versus a modified MBSR program group, and collect data on parental health, positive and negative psychological states, and biomarker indices of stress. Data from pre, mid, and 4 post intervention time points will be used in hierarchical linear modeling, and analyses will also assess if intervention effects differ across mothers, fathers, minority parents, or child diagnoses. Unemployed parents of children with disabilities will be hired as research assistants and trained to conduct either the Parent Group or modified MBSR program interventions. Peer-mentors are effective providers of advocacy and support. Hiring unemployed parents of children with disabilities meets the immediate ARRA mandate and demonstrates the feasibility of hiring parents in future large-scale public health efforts aimed at reducing stress and improving healthy outcomes in the 20% of US families who are raising children with disabilities. PUBLIC HEALTH RELEVANCE: A full 1 in 5 children has a developmental disability, and parents of children with disabilities have significantly high rates of stress, and health and mental health problems than parents of typically- developing children. This study tests the effectiveness of two different interventions, both aimed at reducing stress in parents of children with autism spectrum disorders or other disabilities (a Parent Group model versus a modified Mindfulness-Based Stress Reduction program). This study will shed new light on how to best reduce stress and increase health and well-being in up to 20% of US families who are raising children with developmental disabilities.

The Vanderbilt Kennedy Center for Research on Human Development (VKC), a Eunice Kennedy Shriver Intellectual and Developmental Disability Research Center (EKS-IDDRC), is in its 44th year of support from EKS NICHD. The VKC has experienced remarkable growth in the last five years in its research, service, and training missions. Historically, the VKC has been solely a research center, but the Center's mission has recently expanded to include research, service-outreach, and training. In 2005, the VKC was awarded a University Center of Excellence in Developmental Disabilities (UCEDD), and just this year the Leadership Education in Neurodevelopmental Disabilities (LEND) training program was administratively assigned to the VKC. Synergetic interactions across the IDDRC, UCEDD, and LEND have led to advances in recruiting participants, disseminating research, training new IDD researchers, and conducting translational research. Growth of the VKC is also reflected in the recruitment of 21 new research faculty, and development of state-of-the-science P30 cores to support an expanded basic and clinical science mission. The organizers propose 76 VKC investigators receive P30 support for 91 projects that span both basic and clinical research, with a balance between basic researchers who use model systems to study brain development, mechanisms of neuronal communication, and cellular and functional brain plasticity, and clinical researchers who examine cognitive and linguistic development, emotional regulation, and the impact of disabilities on families. The VKC P30 thus supports research in four major program areas: 1) basic mechanisms associated with typical and atypical development;2) cognitive processes and interventions;3) mental health and interventions;and 4) life impact effects on families and communities. Increasingly, however, VKC investigators cross these traditional boundaries to integrate cognitive and behavioral science with neuroscience and genetic methods to examine autism spectrum disorders;reading, math, and language disabilities;Prader-Willi, Angelman, Williams, and Down syndromes;ADHD;psychosis, depression, and anxiety disorders. To meet the needs of these ambitious research programs, the organizers propose five P30 cores: (A) Administrative;(B) Basic Neuroscience;(C) Statistics and Methodology;(D) Clinical Neuroscience, and (E) Participant Recruitment and Assessment. These cores are generative and advance the basic, clinical, and interdisciplinary research agendas of the VKC, while also creating a vibrant, interactive environment for VKC investigators, families, and trainees.

Core E provides services that promote the successful recruitment and initial assessment of research participants. Core E also provides VKC investigators with access to epidemiologically based study samples. Specifically, Core E has the following aims: *to provide VKC invesfigators with ready access to families and participants with different types of disabilities by going directly to communities of interest locally and statewide, by using web-based materials, and by leading a research participant registry focused on several disability groups; *to offer VKC investigators easy access to novel epidemiological and longitudinal samples via State of Tennessee linked administrafive databases on demographic and health-related variables (e.g., birth, death, marriage, divorce, hospital discharge); *to provide consultation and training to VKC investigators in psychological, cognitive, and behavioral assessments;and *to contribute to the accurate diagnoses of children with autism spectrum disorders (ASD) for the growing number of VKC investigators who need access to this population.

The primary objective of the administrative oversight and Center governance functions of the VKC is to ensure that the Center fulfills its mission in an inclusive, timely, and cost-effective manner. Led by Interim Director Elisabeth Dykens, the VKC administrative leadership works with the Associate Director, Administrator, and Core Directors to provide resources and direction that enable each core to provide costeffective and high-quality support services to VKC investigators and their project staff.

DESCRIPTION (provided by applicant): Funding is requested for a new interdisciplinary postdoctoral training program in Biobehavioral Intervention in Developmental Disabilities (BIDD). The goal of BIDD is to provide postdoctoral trainees with an understanding of the relationships between behavioral phenotypes and biological markers of specific developmental disabilities, and to define the predictive value of these relationships for eventually developing and applying successful interventions. BIDD will thus train a sophisticated, broadly based group of scientists who come from biomedical and behavioral doctoral programs or from medicine, and who are committed to translational research on mental retardation and other developmental disabilities. This novel, well-integrated program takes advantage of a community of Vanderbilt scientists who have actively developed interactive and collaborative research. The training faculty are committed to providing the necessary skills to facilitate integration of knowledge in human behavior, genetics, and developmental neurobiology. BIDD also builds on a tradition of the Vanderbilt Kennedy Center and the Center for Human Genetics Research in promoting multi- and interdisciplinary behavioral and biomedical research in developmental disabilities. Under auspices of faculty from these two Centers, the BIDD program will provide the necessary framework for trainees to engage in complex studies of gene-environment interactions in development, risk factors, neurobiological and functional resiliency, and predictive models of successful intervention. The emerging field of biobehavioral intervention research requires an understanding of the principles of medicine and behavior in order to investigate the etiology and treatment of developmental disabilities. Funds are requested for 5 postdoctoral trainees annually. Trainees will experience intensive research training, along with a mixture of existing courses, seminars and workshops. In addition, trainees will take advantage of clinical experiences, in the form of rotations, which can be selected from existing genetics, autism, behavioral pediatric and educational clinics. Trainees will come from the fields of clinical medicine, genetics, developmental neurobiology, special education and psychology, reflecting the breadth of training faculty. BIDD includes research efforts that are particularly relevant to the goal of developing better tools for diagnosis and new interventions for children, adolescents and adults with developmental disabilities. The program will facilitate ongoing, interdisciplinary application of interventions, either behavioral (e.g. cognitive training) or biological (e.g. pharmacological), in the community.

DESCRIPTION (provided by applicant): Prader-Willi syndrome (PWS) is a complex, genetic neurodevelopmental disorder characterized by intellectual disabilities; compulsivity; tantrums; irritability; growth hormone dysfunction; hyperphagia; and increased risks of morbid obesity, psychosis, and autism spectrum disorders (ASD). Caused by a lack of paternally-derived imprinted material on 15q11-q13, Prader-Willi syndrome (PWS) remains a life-threatening and extremely challenging disorder for families to manage. This renewal builds on our success over the last grant period by identifying differential developmental trajectories based on Type I, Type II, and maternal UPD genotypes of PWS; examining other factors that impact these trajectories; and refining how we measure psychiatric outcomes across age. Over the next 5 years, we will follow 168 people with PWS aged 4 years through adulthood using a longitudinal, random coefficients slope-as-outcome model. Aim 1 identifies the lifespan trajectories of IQ, adaptive skills, hyperphagia, and psychopathology within the three main PWS genotypes. We expect that: Type I deletion cases will decline in IQ, adaptive skills and behavior problems; Type II cases will remain relatively stable; and those with mUPD will worsen psychiatrically but at the same time improve cognitively. Differences between Type I and Type II trajectories will relate to the expression of specific genes such as CYFIP1. Aim 2 examines other factors that impact trajectories, including the unstudied, non-body composition effects of growth hormone treatment, fluctuations in degree of obesity, and serotonin-altering genes (e.g., TPH-2, 5HTTLPR). Aim 3 refines how psychiatric outcomes in PWS are measured in trajectories by including but moving beyond psychiatric diagnoses (e.g., ASD, depression, psychosis) and identifying, for the first time, specific symptoms of these disorders, and those social, cognitive, and neural processes that are associated with these symptoms. Trajectories across the lifespan are more accurate than cross-sectional approaches, and analyses of trajectories will shed new light on differences across PWS genotypes, risks for ASD or psychosis, and how and when to best intervene to reduce problems and enhance positive outcomes in this syndrome.

Project Summary/Abstract The Gatlinburg Conference on Research and Theory in Intellectual and Developmental Disabilities is an annual scientific meeting at which an interdisciplinary group of investigators present and discuss cutting-edge biobehavioral theory and research on intellectual and developmental disabilities (IDD). The conference focuses on the causes, consequences, and treatments and interventions for specific disorders as well as processes underlying IDD more generally. Each year's conference has a scientific theme which is explored through keynote presentations, but the theme does not constrain the symposia or poster sessions, which span a broad range of topics, from basic to translational and applied science. The specific aims are: 1. to foster the infusion of perspectives, methods, and theories from related fields into IDD research and to promote the exchange of scientific information, theoretical perspectives, and methodological innovations relevant to IDD. 2. to promote collaborative research on IDD, bringing together an interdisciplinary group of investigators ranging from behavioral and social scientists to those specializing in genetics, brain structure and function, and molecular biology. 3. to serve as a unique training and career development resource for graduate students, postdoctoral fellows, and other early career scientists entering the field of IDD research by providing them with access to cutting- edge scientific presentations, opportunities for networking, and exposure to NIH program and review leadership, particularly those associated with the IDD Branch of NICHD.

Core E provides services that promote the successful recruitment and initial assessment of research participants. Core E also provides VKC investigators with access to epidemiologically based study samples. Specifically, Core E has the following aims: *to provide VKC invesfigators with ready access to families and participants with different types of disabilities by going directly to communities of interest locally and statewide, by using web-based materials, and by leading a research participant registry focused on several disability groups; *to offer VKC investigators easy access to novel epidemiological and longitudinal samples via State of Tennessee linked administrafive databases on demographic and health-related variables (e.g., birth, death, marriage, divorce, hospital discharge); *to provide consultation and training to VKC investigators in psychological, cognitive, and behavioral assessments; and *to contribute to the accurate diagnoses of children with autism spectrum disorders (ASD) for the growing number of VKC investigators who need access to this population.

? DESCRIPTION (provided by applicant): This U54 application seeks renewed funding for Vanderbilt University's Intellectual and Developmental Disabilities Research Center (IDDRC), based in Vanderbilt's Kennedy Center. Vanderbilt's IDDRC includes the full range of basic, clinical, and intervention scientists necessary to fulfill the goals for the EKS NICHD IDDRC program of translational research that improves the lives of people with intellectual and developmental disabilities (IDD) and their families. Our IDDRC focuses on elucidating mechanisms and effective interventions for individuals with autism spectrum disorders, learning disabilities, genetic IDD syndromes, and acquired IDDs. Within each of these groups, IDDRC investigators discover underlying disease mechanisms, treatment targets, and aberrant developmental processes in model systems; assess cognitive, social, emotional, and neural phenotypes; and conduct innovative treatment and intervention studies. These activities are embodied in the U54 Research Project, Sensory and Multisensory Contributions to Autism, which meets the EKS NICHD Focus Theme #2: Outcome Measures for Interventions, and highlights an understudied but increasingly recognized characteristic of autism. Vanderbilt's U54 IDDRC includes 46 investigators from 15 academic departments who lead 69 research projects; 14 are funded by the EKS NICHD. We propose five exceptional, non-duplicative IDDRC Cores to support these investigators and that are also integrated into each Specific Aim of the U54 Research Project. The Administrative Core A provides scientific direction, manages IDDRC governance committees and activities, and leads innovative training and educational programs. Clinical Translational Core B meets investigators' immediate needs for recruiting and phenotyping participants with IDDs, while also assisting with clinical trials, mining novel epidemiological data for IDD phenotyping, and building a new resource of IDD outcome measures. Translational Neuroimaging Core C assists investigators with neuroimaging and psychophysiology data acquisition, processing, and analyses; creates novel experimental paradigms, and proposes big data approaches for large-scale investigations of IDD. Neuroscience Core D provides essential and inherently generative services in mouse neurobehavioral phenotyping, neurochemistry, molecular neurobiology and genomics, and scientific instrumentation, which designs, constructs, or repairs specialized research equipment. Biostatistics and Bioinformatics Core E improves research quality with expert biostatistical consultation and training on topics that are relevant to IDDs, and also develops unique bioinformatics databases of electronic medical record data from patients with IDDs that are linked to their DNA. IDDRC Cores are thus customized to meet the immediate needs of our investigators, and also to generate novel, forward-thinking technologies, tools, or resources that drive innovative discoveries aimed at understanding and ameliorating IDDs.

CLINICAL TRANSLATIONAL CORE B ABSTRACT Project Summary Core B is the U54?s translational bridge, providing essential services that enable researchers to test their hypotheses in people with autism spectrum disorders, learning disabilities, genetic syndromes, or other IDDs. Translational research depends on successfully recruiting volunteers with disabilities into studies, and characterizing them in ways that shed light on the questions or treatments under study. Core B provides these important recruitment and phenotyping services, with more intensive support for basic science colleagues who are less familiar with the intricacies of human studies. At the same time, however, the core develops innovative resources that advance translational science in four, interrelated Aims: Aim 1. Develop and implement multi-faceted strategies for successfully recruiting families and individuals with IDDs into research. Aim 1 services integrate with Core A?s communication and education goals (A5.1, 5.2), and also advance a new, national IDD Sub-Registry of the CTSA-supported ResearchMatch. The IDD Sub-Registry stands to benefit other IDDRCs in our national network. Aim 2. Grow the IDDRC?s autism and Down syndrome clinical research registries, and State of TN epidemiological databases, in both number of registrants and phenotypic complexity. This Aim facilitates recruitment and unique data mining resources for complementary clinical and population-based IDD studies. Aim 3. Advance multi-method approaches to measure the complex phenotypes of individuals with IDDs in descriptive or treatment studies, including promising new assessments in Core C (C4.2.3) and the U54 Research Project. Using the REDCap platform, Aim 3 also builds a novel, annotated collection of outcome measures used in IDD trials or interventions; a step toward filling a gap in the field underscored by NICHD. Aim 4. Provide extensive consultative and coordinating services for basic scientists embarking on human, IDD translational studies, which necessarily entails work with all others in all U54 Cores. This Aim also helps both basic and clinical investigators navigate VUMC?s Clinical Trials Center, which provides efficient administrative trial support, but lacks expertise in IDDs that is instead provided by Core B. Core B?s scientific generativity stems from both the 26 highly productive Core B users leading 43 projects, and from the development of new, forward-thinking core resources. These new directions allow IDDRC investigators to leverage their discoveries into more optimal treatments or interventions that improve the lives of people with IDDs and their families.

ADMINISTRATIVE CORE A ABSTRACT Project Summary The Aims of IDDRC Administrative Core A are (1) to provide scientific leadership that meets the EKS NICHD?s overarching mission for the IDDRCs and is consistent with the principles and administrative policies of Vanderbilt University; (2) to responsibly manage, administer, and oversee the fiscal and other resources of the IDDRC, thereby optimizing core functions for IDDRC investigators and the U54 Research project; (3) to communicate and to disseminate novel research findings, evidence-based practices, and recruitment needs to the general public and pertinent professional or disability organizations; and (4) to organize and to coordinate IDDRC Training and Education and other activities that promote the professional development of trainees and investigators alike, and that foster a vibrant community working toward shared goals of translational discoveries in IDD. Services of Administrative Core A are (a) IDDRC administration, core and research project oversight, and governance; (b) extramural grants administration; IDDRC Nicholas Hobbs Discovery Grants administration; information technology support and graphics; and Training and Education activities. Core A provides scientific direction and integration for an IDD translational research program building on IDDRC strengths in neuroscience and behavioral sciences. It provides administrative oversight of the IDDRC research mission, its cores, and Research Project. Center governance mechanisms include the Executive Committee, which includes the Senior Administrative Committee and IDDRC Research and Core Services Committee; External Advisory Committee; Membership Committee; and IDD family/community input from Community Advisory Council and Community Partners. Core A?s fiscal and resource management includes proactive support for extramural grants development and grants administration. It administers the IDDRC Hobbs Discovery Grants, supported by philanthropy, to fund innovative IDD pilot research that may yield new approaches, methods, or interventions. It manages IDDRC space and facilities. Technical and graphics services facilitate IDD research, research publications, core management, internal and external electronic and print communication, and training and education. The core leads Training and Education and related communication activities for multiple audiences (e.g., pre- and postdoctoral trainees, IDD researchers, IDDRC network, IDD-related professionals, children/adults with IDD/families) and purposes (e.g., research participation, disseminating research findings and evidence-based practices) at multiple levels: IDDRC, Vanderbilt, community, State, and national.